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NCT Number: NCT07739303

Anterior Suprascapular and Axillary vs. Interscalene Block for Analgesia and Diaphragmatic Function in Shoulder Surgery

Shoulder surgeries are among the most frequently performed orthopedic interventions and are often associated with moderate to severe postoperative pain. In these procedures, effective pain management is crucial for early rehabilitation and patient comfort.

Peripheral nerve blockade is widely used for postoperative analgesia in shoulder surgery. While the interscalene brachial plexus block is considered the gold standard for pain control, it is frequently associated with unintended phrenic nerve blockade, leading to hemidiaphragmatic paresis. To minimize respiratory complications while maintaining effective analgesia, alternative diaphragm-sparing regional anesthesia techniques, such as the combination of suprascapular and axillary nerve blocks, have been introduced.

The aim of this study is to compare the analgesic efficacy and respiratory functions preservation of the ultrasound-guided anterior approach suprascapular combined with axillary nerve block versus interscalene block in patients undergoing shoulder surgery

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Key information

Conditions

Peripheral Nerve Block Agnosia Diaphragm Protective Block Interscalene Block Nervous System Diseases Neurobehavioral Manifestations Neurologic Manifestations Pain Management Pathological Conditions, Signs and Symptoms Perceptual Disorders Signs and Symptoms Upper Extremity

Age range

18 year–65 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Patients aged between 18 and 65 years
  • American Society of Anesthesiologists (ASA) physical status I, II, or III
  • Patients scheduled to undergo elective arthroscopic shoulder surgery
  • BMI between 18 and 30 kg/m2
  • Ability to provide written informed consent

Exclusion criteria

  • Known allergy or hypersensitivity to local anesthetics
  • Presence of localized infection at the planned injection site
  • Severe coagulopathy or active use of anticoagulant medications
  • Contralateral phrenic nerve palsy or a diagnosis of severe chronic obstructive pulmonary disease (COPD)
  • History of chronic opioid consumption or neuropathic pain

Treatment and study plan

interscalene block

Procedure

Interscalene block will be performed on the patients using 10 mL of 0.5% bupivacaine under ultrasound guidance.

Combination of Axillary and Anterior Suprascapular Blocks

Procedure

Combined anterior suprascapular(5 ml) and axillary nerve blocks(5 ml) will be performed on the patients using a total of 10 mL of 0.5% bupivacaine under ultrasound guidance.

Primary outcomes

  1. Postoperative Pain Intensity at Rest

    Time frame: 4 hours after surgery.

    Pain will be assessed using a visual analog scale from 0 mm (no pain) to 100 mm (worst pain) at rest. Pain assessment at rest will be made at 4 hours after surgery.

Secondary outcomes

  1. Postoperative Pain Intensity at Rest

    Time frame: Up to 24 hours

    Pain will be assessed using a visual analog scale from 0 mm (no pain) to 100 mm (worst pain) at rest. Pain assessment at rest will be made at 1, 8, 12, and 24 hours after surgery.

  2. Postoperative Pain Intensity at Movement

    Time frame: Up to 24 hours

    Pain will be assessed using a visual analog scale from 0 mm (no pain) to 100 mm (worst pain) at movement. Pain assessment at rest will be made at 1, 4, 8, 12, and 24 hours after surgery.

  3. Total Postoperative Opioid Consumption

    Time frame: Up to 24 hours

    The total amount of opioid consumed by the patient will be recorded.

  4. Area Under Curve

    Time frame: At the 24th hour

    Cumulative 24-hour pain burden calculated by the trapezoidal rule

  5. Diaphragmatic Excursion

    Time frame: Baseline (immediately before block performance) and 30 minutes after block performance

    Diaphragmatic excursion will be measured in centimeters (cm) using M-mode ultrasonography during normal breathing and deep breathing (sniff test).

  6. Forced vital capacity (FVC) (volume)

    Time frame: Perioperative period

    Forced vital capacity (FVC) (volume) will be evaluated during the perioperative period. Measurements will be performed before block administration (baseline), at 30 minutes after the block, and at postoperative 1 and 24 hours.

  7. Forced expiratory flow in 1 s (FEV1) (volume)

    Time frame: Perioperative period

    Forced expiratory flow in 1 s (FEV1) (volume) will be evaluated during the perioperative period. Measurements will be performed before block administration (baseline), at 30 minutes after the block, and at postoperative 1 and 24 hours.

  8. FEV1/FVC

    Time frame: Perioperative period

    FEV1/FVC will be evaluated during the perioperative period. Measurements will be performed before block administration (baseline), at 30 minutes after the block, and at postoperative 1 and 24 hours.

Study contacts

Contact information is provided by the study sponsor or research team.

Musa Zengin

CONTACT

[email protected]

+905307716235

İbrahim Topcu

CONTACT

[email protected]

+905437860316

Sponsors and collaborators

Lead sponsor

Ankara Etlik City Hospital

Other Gov

Registry information

Official study title

Comparison of Anterior Suprascapular and Axillary Nerve Block Versus Interscalene Block for Postoperative Analgesia and Diaphragmatic Function in Shoulder Surgery: A Randomized Controlled Trial

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
Jul 31, 2026
Registry last updated
Jul 31, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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